25(OH)D3 in patients with ovarian cancer and its correlation with survival

OBJECTIVES

The aim of this study was to examine vitamin 25(OH)D3 concentration in ovarian cancer patients in relation to a pathological subtype of the tumor, FIGO stage, grading, menopause status and overall 5-year survival.

DESIGN AND METHODS

72 epithelial ovarian cancer patients aged 37-79, who undergone optimal cytoreductive surgery were enrolled to the study group. Serum 25(OH)D3 concentration was measured using an electrochemiluminescence immunoassay before surgery. Serum concentration of 25(OH)D3 was also measured in a group of 65 healthy non-obese women aged 35-65 years.

RESULTS

In patients with ovarian cancer serum concentration of 25(OH)D3 was lower than in the reference group (12.5±7.75 ng/mL vs 22.4±6.5 ng/mL). No significant correlation was found between serum 25(OH)D3 concentration and histological subtype, grading, FIGO stage and menopausal status. The study group was divided into two subgroups and the survival curves were analyzed. Overall 5-year survival rate was significantly higher in the subgroup of patients with 25(OH)D3 concentration over 10 ng/mL compared to women with concentration below 10 ng/mL.

CONCLUSIONS

Low 25(OH) D3 concentration associated with lower overall survival rate might suggest for the important role of severe deficiency in more aggressive course of ovarian cancer. Testing for 25(OH)D in the standard procedure could help to find ovarian cancer patients with worse prognosis, who would benefit of special attention and supplementation.

[Concentrations of MMP-1, TIMP-1, MMP-1/TIMP-1 and I CTP complexes in follicular fluid as related to fertilization rate in women treated with in-vitro fertilization]

OBJECTIVES

Metalloproteinases and their inhibitors appear to control connective tissue remodelling during follicular rupture. The aim of the study was to establish if oocytes fertilisation rate after ovulation induction depends on the concentrations of MMP-1, its inhibitor TIMP-1, MMP-1/TIMP-1 complex and I CTP in follicular fluid (FF).

MATERIAL AND METHODS

FF were collected from 37 infertile patients undergoing ovulation induction using either short or long protocol. FF was obtained 36 hours after administration of hCG (Pregnyl). The level of MMP-1, TIMP-1, MMP-1/TIMP-1 complex were measured using ELISA kits and I CTP, E2, FSH, LH, using RIA assay kits.

RESULTS

Statistically significant (p < 0.05) difference was found in TIMP-1, E2, and FSH concentration, being higher in the group with more than 75% fertilisation rate: TIMP-1 728.8 + 100.1 ng/ml vs 666.3 + 94.5 ng/ml; E2 477.3 +/- 160.0 ng/ml vs 368.0 +/- 190.0 ng/ml and FSH 7.27 +/- 1.45 mIU/ml vs 6.24 +/- 1.6 mIU/ml.

CONCLUSIONS

Statistically significant increase in TIMP-1 concentration observed among patients with fertilisation rate above 75% indicates an important role of this substance in ovulation process.

[Evaluation of using Levovist in the differential diagnosis of ovarian tumors]

The research on applying Levovist was carried out in the Department of Obstetrics and Gynaecology of Medical Academy in Bydgoszcz, Poland, in the years 1997-1998. Out of 118 hospitalised patients with preliminary diagnosis: tu. hypogastrii, tu. adnexorum, tu. ovarii, cystis ovari, due to the suspicious ultrasound result, and/or decreased parameters of arterial blood flow (PI < 1.0; RI < 0.6) and or presence of abdominal fluid, 32 women were included in the study. The changes in the Doppler image under the influence of Levovist and their correlation with histologic features were analysed. The time span between injection of Levovist and the enhancement of the Doppler image was not characteristic for any tumor. However, it was observed, that the mean return time i.e. from the enhancement of the Doppler signal to the initial pattern, was considerably longer in carcinomas than in other ovarian tumours. No signal enhancement was observed in benign lesions.

[Struma ovarii: rare ovarian neoplasm]

Authors of this research present 3 cases of struma ovarii diagnosed in postoperative histopathological examination in years 1994-1997. The first one was accidentally discovered during examination of a woman in menopausal period, the second was a case of 39-years old woman with hyperthyroidism and struma parenchymatoso-nodosa and the third was detected during examination of a young 21-years old woman with abdominal pain. In first two cases Doppler flowmetry revealed low RI and PI parameters (< 0.5 and < 0.7 respectively) in tumor structures.

[Evaluation of ovarian tumor vascularization by means of intravaginal ultrasonography with color Doppler]

53 cases of ovarian tumors were diagnosed and operated in the Clinic of Obstetrics and Gynecology of Medical Academy in Bydgoszcz in years 1996-1997. Retrospective analysis of 58 results of ultrasonographic examination with color-Doppler estimated flows and histopathological diagnoses in cases of ovarian tumor was performed. On the ground of sonographically estimated morphology, presence or absence of vascularization and pulsation and resistance indices (PI and RI respectively) an attempt to discriminate benign and malignant tumors was made. Values of RI > 0.6 and PI > 1.0 in absence of morphologically suspicious features in ultrasonographic examination correlated with benign forms of ovarian tumors in histological examination.

[HSG--usefulness in diagnosing infertility]

HSG examination was performed on 363 female patients diagnosed because of infertility. In 258 (71.8%) women primary infertility was recognized and in 105 (28.9%) secondary infertility. Normal anatomical state of Fallopian tube was observed in 65 (77.4%) patients with primary infertility and only in 19 (22.6%) with secondary infertility. Abnormal results of examination were discovered in altogether 279 (76.9%) diagnosed patients. Taking into consideration Fallopian tube factor in secondary infertility, it was discovered in as many as 81.9% of cases.

[Laparoscopic evaluation of small pelvic adhesions in female patients treated for infertility]

The range and nature of adhesions found out by means of laparoscopy was analysed in patients diagnosed because of infertility. 38% of patients had laparotomy performed previously. Adhesions concerned 47% of the reproductive organ, although in nearly the same percentage intestine and greater omentum were involved. In 13 (31%) patients occurrence of endometriosis focus was discovered. In the area of Fallopian tube--ovary there were most often non-vascularized, thin adhesions and solid adhesions in the area of Douglas sinus.

[Socio-medical conditioning of marital infertility]

An inquiry was carried out among 185 women diagnosed because of infertility. The questionnaires included personal data, obstetric information from the past and information concerning earlier attempts at diagnosing and treating both partners. Authors of this article are of the opinion that infertile couples, especially from the country, decide only too late to find out the causes of the infertility. Taking into consideration the range of present day knowledge, the authors point out that highly specialized centres should deal with diagnosing and treating infertility.